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Pancreatic injury.

Martha Quiodettis traumahst at gmail.com
Sat Apr 2 07:08:01 BST 2016

Need advice in a difficult case. 58 yo Female. POD# 10.   GSW to upper abdomen. Injuries to stomach, first portion of duodenum, pancreas, liver and right colon. (Do not know all the details of this surgery since it was performed in other hospital) 
E-lap, duodenum, stomach primary repair+ liver and pancreas hemostasis and drains +
Right side hemicolectomy and ileo- colon transverse anastomosis. 
Today transferred to the hospital I work. Hemodynamically stable. Ventilated. Looks not so sick. All drainages with dark fluid. 
Abdominal CT made today showed a fluid collection with gas above the liver and in right goiter plus total transection of the body of pancreas. 
What do you do in a patient like this?
Percutaneous drainage???  E lap +
Distal pancreatectomy 10 days after an injury?  try ERCP and pancreatic stent?? 

Dra. Martha Quiodettis MD. FACS

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